#3392 of 11K

M0247

HCPCS Procedure Code

HCPCS code M0247 is the #3,392 most-billed Medicaid procedure code, with $1.8M in payments across 7K claims from 2018–2024. The national median cost per claim is $235.71.

Total Paid

$1.8M

0.00% of all spending

Total Claims

Providers

212

Avg Cost/Claim

$240

National Cost Distribution

How much do providers bill per claim for M0247? Based on 200 providers billing this code nationally.

Median

$235.71

Average

$235.89

Std Dev

$197.18

Max

$2,159.95

Percentile Distribution (Cost per Claim)

p10

$32.59

p25

$140.81

Median

$235.71

p75

$291.38

p90

$378.58

p95

$442.45

p99

$819.03

50% of providers bill between $140.81 and $291.38 per claim for this code.

90% bill between $32.59 and $378.58.

Top 1% bill above $819.03.

About This Procedure

HCPCS code M0247 was billed by 212 providers across 7K claims, totaling $1.8M in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$235.71

Providers Billing

200

National Spending

$1.8M

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0247

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Banner - University Medical Center Phoenix Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic	$110K	$816.07	3.5× median	Top 10%
2	1194758284	$102K	$1,112.35	4.7× median	Top 1%
3	Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital	$70K	$232.66	1.0× median	Below Median
4	1841266194	$41K	$197.76	0.8× median	Below Median
5	1700816048	$38K	$235.61	1.0× median	Below Median
6	1629201264	$36K	$399.69	1.7× median	Top 10%
7	The Moses H. Cone Memorial Hospital Operating Corporation Greensboro, NC · General Acute Care Hospital	$33K	$271.18	1.2× median	Above Median
8	1063923340	$30K	$2,159.95	9.2× median	Top 1%
9	1518018191	$28K	$592.32	2.5× median	Top 10%
10	1023331303	$28K	$319.70	1.4× median	Above 75th
11	Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder	$28K	$290.75	1.2× median	Above Median
12	1588298053	$27K	$311.64	1.3× median	Above 75th
13	1619923919	$25K	$295.85	1.3× median	Above 75th
14	Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital	$24K	$260.02	1.1× median	Above Median
15	1831132133	$24K	$262.77	1.1× median	Above Median
16	1891706461	$22K	$288.00	1.2× median	Above Median
17	1841253937	$21K	$289.48	1.2× median	Above Median
18	Banner-university Medical Group Phoenix, AZ · Clinic/Center, Primary Care	$21K	$185.48	0.8× median	Below Median
19	Ohio State University Hospitals Columbus, OH · General Acute Care Hospital	$21K	$237.56	1.0× median	Above Median
20	1851805022	$20K	$235.81	1.0× median	Above Median

Showing top 20 of 212 providers billing this code

Related Procedures

M0243$13.3M M0240$7.5M M0241$6.8M M0245$2.8M M0244$1.3M

← All procedures Top providers →